Department of Human Biological Development, Institute of Anthropology, Faculty of Biology, Adam Mickiewicz University, Ul. Umultowska 89, 61-614, Poznan, Poland.
Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, SO17 1BJ, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, SO17 1BJ, UK; Solent NHS Trust, Southampton, SO19 8BR, UK; New York University Child Study Center, New York, NY, 10016, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
Neurosci Biobehav Rev. 2018 Sep;92:16-28. doi: 10.1016/j.neubiorev.2018.05.017. Epub 2018 May 19.
Available meta-analyses point to a significant association between attention-deficit/hyperactivity disorder (ADHD) and obesity. The possible mechanisms underlying this relationship are unclear. Here, we overview the studies aimed at identifying the factors contributing to the comorbidity between ADHD and obesity, including genetic factors, fetal programming, executive dysfunctions, psychosocial stress, factors directly related to energy balance, and sleep patterns alterations. The bulk of current research has focused on reduced physical activity and abnormal eating patterns as possible causes of weight gain in individuals with ADHD. Further research is needed to explore the specific role of executive dysfunctions. None of the available published studies have evaluated physiological mechanisms such as hormonal and metabolic disorders or inappropriate neurobiological regulation of appetite. Research exploring the genetic basis for the coexistence of ADHD and obesity and epigenetic mechanisms, with particular emphasis on stress, both pre- and postnatal, seems particularly promising. Here, we propose a biopsychosocial model to integrate current findings and move the field forward to gain insight into the ADHD-obesity relationship.
现有的荟萃分析表明,注意力缺陷多动障碍(ADHD)与肥胖之间存在显著关联。但这一关系背后的潜在机制尚不清楚。在这里,我们综述了旨在确定 ADHD 和肥胖共病相关因素的研究,包括遗传因素、胎儿编程、执行功能障碍、心理社会压力、与能量平衡直接相关的因素以及睡眠模式改变。目前的大部分研究都集中在减少体力活动和异常的饮食模式上,这些可能是 ADHD 患者体重增加的原因。需要进一步研究来探索执行功能障碍的具体作用。目前还没有研究评估生理机制,如激素和代谢紊乱或食欲的不适当神经生物学调节。探索 ADHD 和肥胖共存的遗传基础和表观遗传机制的研究似乎特别有前途,特别强调了产前和产后的应激。在这里,我们提出了一个生物心理社会模型来整合当前的研究结果,并推动该领域的发展,以深入了解 ADHD-肥胖的关系。